Friday, July 13, 2012
Thursday, July 12, 2012
Wednesday, July 11, 2012
Cisplatin plus paclitaxel and maintenance of (Avastin) bevacizumab on tumour progression, dissemination, and survival of ovarian carcinoma xenograft models
Cisplatin plus paclitaxel and maintenance of bevacizumab on tumour progression, dissemination, and survival of ovarian carcinoma xenograft models:
July 2012 doi:10.1038/bjc.2012.261
Background:
Bevacizumab is being
incorporated as first-line therapy with standard-of-care chemotherapy on
epithelial ovarian carcinoma (EOC). We investigated bevacizumab
combined with chemotherapy on tumour progression and mouse survival in
EOC xenograft models.
Methods:
Bevacizumab was administered concomitantly with cisplatin plus paclitaxel (DDP+PTX),
continued after induction (maintenance) or started after chemotherapy.
The effect on tumour progression was monitored by bioluminescence
imaging (BLI) (1A9-luc xenograft). Tumour dissemination into the
peritoneal organs and ascites formation (HOC22 xenograft) was evaluated
by histological analysis at the end of treatment (interim) and at
euthanasia (survival). The effects on overall survival (OS) were
investigated in both EOC models.
Results:
Bevacizumab with PTX+DDP
delayed tumour progression in mice bearing EOC xenografts. OS was
significantly extended, with complete responses, by bevacizumab
continued after stopping chemotherapy in the HOC22 xenograft.
Bevacizumab alone inhibited ascites formation, with only limited effect
on tumour burden, but combined with PTX+DDP reduced ascites and metastases. Bevacizumab started after induction with PTX+DDP and maintained was equally effective on tumour progression and survival on 1A9-luc xenograft.
Conclusion:
Bevacizumab
combined with chemotherapy not only affected tumour progression, but
when administered as maintenance regimen significantly prolonged
survival, reducing ascites, and tumour dissemination. We believe our
findings are consistent with the clinical results and shed light on the
potential effects of this kind of treatment on tumour progression.
paywalled: Preferences for outcomes associated with decisions to undergo or forego genetic testing for Lynch syndrome
Preferences for outcomes associated with decisions to undergo or forego genetic testing for Lynch syndrome
Abstract
BACKGROUND:
Current
guidelines recommend offering genetic testing for Lynch syndrome to
individuals whose tumors suggest this condition and to relatives of
affected individuals. Little is known, however, regarding how patients
view the prospect of such testing. In addition, data on preferences
(utilities) for the potential outcomes of testing decisions for use in
cost-effectiveness analyses are lacking.
METHODS:
Time
tradeoff utilities were elicited for 10 potential outcomes of Lynch
syndrome testing decisions and 3 associated cancers from 70
participants, representing a range of knowledge about and experiences
with Lynch syndrome.
RESULTS:
Highest
mean utilities were assigned to scenarios in which only the assessor's
sibling had Lynch-associated colorectal cancer (ranging from 0.669 ±
0.231 to 0.760 ± 0.220). Utilities assigned to scenarios in which the
assessor had Lynch-associated colorectal cancer ranged from 0.605 ±
0.252 to 0.682 ± 0.246, whereas the lowest mean utilities were assigned
to 2 of the general cancer states (0.601 ± 0.238 and 0.593 ± 0.272 for
colorectal and ovarian cancer respectively). Only 43% of the sample
assigned higher values to undergoing Lynch testing and receiving
negative results versus foregoing Lynch testing, whereas 50% assigned
higher values to undergoing rather than foregoing surgery to prevent a
subsequent cancer.
CONCLUSIONS:
Genetic
testing for Lynch syndrome, regardless of results, can have profound
effects on quality of life; the utilities we collected can be used to
incorporate these effects into cost-effectiveness analyses. Importantly,
preferences for the potential outcomes of testing vary substantially,
calling into question the extent to which patients would avail
themselves of such testing if it were offered to them. Cancer 2012. ©
2012 American Cancer Society
Podcast/RSS video: Lynch Syndrome Educational Support Workshop | Memorial Sloan-Kettering Cancer Center (68 min.)
Podcast/RSS video: Lynch Syndrome Educational Support Workshop | Memorial Sloan-Kettering Cancer Center
Runtime
68:00
Medical experts from Memorial Sloan-Kettering discuss Lynch syndrome, a genetic disorder that can cause colon and other cancers.
Tuesday, July 10, 2012
paywalled: Gynecologic Oncology Impact of Complete Cytoreduction Leaving No Gross Residual Disease Associated with Radical Cytoreductive Surgical Procedures on Survival in Advanced Ovarian Cancer
Impact of Complete Cytoreduction Leaving No Gross Residual Disease Associated with Radical Cytoreductive Surgical Procedures on Survival in Advanced Ovarian Cancer
Abstract
Background
To
analyze the impact of radical cytoreductive surgery—as part of primary
tumor debulking—on the amount of residual tumor
and survival in patients with advanced ovarian cancer
and to evaluate the prognostic significance of no gross residual disease
(RD) after surgery.
Methods
Medical
records of 203 patients with International Federation of Gynecology and
Obstetrics (FIGO) stage IIIC–IV ovarian cancer
were reviewed. All patients underwent primary
cytoreductive surgery followed by taxane- and platinum-based
chemotherapy. Various
clinicopathologic characteristics were collected.
Results
Of 203 patients, 119 patients underwent simple surgery, while radical surgery was performed in 84 patients..........
Conclusions
No gross RD is associated with improved overall survival, and radical surgery was effective for achieving no gross RD.
Monday, July 09, 2012
Medscape: Hormone Therapy and Different Ovarian Cancers
Hormone Therapy and Different Ovarian Cancers (mobile format): Abstract and Introduction
Sent using the Medscape App for iPhone®
Sunday, July 08, 2012
10 years after hormone therapy study: What doctors know now – USATODAY.com
10 years after hormone therapy study: What doctors know now – USATODAY.com
"It's been 10 years since researchers of the Women's Health Initiative, a large randomized, controlled trial on hormone therapy sponsored by the National Institutes of Health, announced their first findings: that the health risks outweighed the benefits of estrogen plus progestin hormone therapy (HT) in postmenopausal women. Since then, additional research has advanced the understanding of the benefits and risks. JoAnn Manson, one of the study's lead investigators and a professor of medicine at Harvard Medical School, is the president of the North American Menopause Society. She spoke with USA TODAY's Janice Lloyd about what women need to know to get through the challenging time and to protect their health......
Mismatch Repair Protein Deficiency - sebaceous carcinoma
Mismatch Repair Protein Deficiency is Common in Sebaceous Neoplasms and Suggests the Importance of Screening for Lynch Syndrome.
Ovarian metastases resection from extra - PubMed Mobile
http://www.ncbi.nlm.nih.gov/m/pubmed/22759383/?i=4&from=ovarian%20cancer&filter=loattrfree%20full%20text
"CONCLUSION: Ovarian metastases are more commonly seen to originate from primary gastrointestinal tract. The prognosis of ovarian metastasis is dismal and the benefit of ovarian metastatectomy is limited. Those with combined metastasis outside ovaries, locally invasion and massive intraoperative ascites were independent factors for predicting unfavorable overall survival. The identification of the primary tumor is required to plan for adequate treatment for this group of patients."
Sent from my iPhone
paywalled: Dairy foods and nutrients in relation to risk of ovarian cancer and major histological subtypes - Merritt - International Journal of Cancer - Wiley Online Library
Dairy foods and nutrients in relation to risk of ovarian cancer and major histological subtypes
Abstract
Inconsistent results for the role of dairy food intake in relation to ovarian cancer risk may reflect the potential adverse effects of lactose, which has been hypothesized to increase gonadotropin levels, and the beneficial anti-proliferative effects of calcium and vitamin D. Using data from the New England case-control study (1909 cases; 1989 controls) we examined dairy foods and nutrients in relation to risk of ovarian cancer overall, histological subtypes, and rapidly fatal versus less aggressive disease. We used logistic regression and polytomous logistic regression to estimate odds ratios and 95% confidence intervals. In models that were simultaneously adjusted for total (dietary plus supplements) calcium, total vitamin D and lactose, we observed a decreased overall risk of ovarian cancer with high intake of total calcium (Quartile 4 (Q4, >1319 mg/day) vs. Quartile 1 (Q1, <655 mg/day), odds ratio (OR)=0.62, 95% Confidence Interval (CI)=0.49 - 0.79); the inverse association was strongest for serous borderline and mucinous tumors. High intake of total vitamin D was not associated overall with ovarian cancer risk, but was inversely associated with risk of serous borderline (Q4, >559 IU/day vs. Q1, <164 IU/day, OR=0.51, 95% CI=0.34-0.76) and endometrioid tumors (Q4 vs. Q1, OR=0.55, 95% CI=0.39-0.80). We found no evidence that lactose intake influenced ovarian cancer risk, or that risk varied by tumor aggressiveness in the analyses of intake of dairy foods and nutrients. The overall inverse association with high intake of calcium, and the inverse associations of calcium and vitamin D with specific histological subtypes warrant further investigation.paywalled: Phenotype and Polyp Landscape in Serrated Polyposis Syndrome: A Series of 100 Patients From Genetics Clinics (Lynch Syndrome...)
define: hyperplastic
What is a hyperplastic colon polyp?
hyperplastic colon polyps~~~~~~~~~~~~~~~~~~~~~~~~~~
Phenotype and Polyp Landscape in Serrated Polyposis Syndrome: A Series of 100 Patients From Genetics Clinics
Abstract
Serrated polyposis syndrome (SPS), also known as
hyperplastic polyposis, is a syndrome of unknown genetic basis defined
by the occurrence of multiple serrated polyps in the large intestine and
associated with an increased risk of colorectal cancer (CRC). There are
a variety of SPS presentations, which may encompass a continuum of
phenotypes modified by environmental and genetic factors. To explore the
phenotype of SPS, we recorded the histologic and molecular
characteristics of multiple colorectal polyps in patients with SPS
recruited between 2000 and 2010 from genetics clinics in Australia, New
Zealand, Canada, and the United States. Three specialist
gastrointestinal pathologists reviewed the polyps, which they classified
into conventional adenomas or serrated polyps, with various subtypes,
according to the current World Health Organization criteria. Mutations
in BRAF and KRAS and mismatch repair protein
expression were determined in a subset of polyps. A total of 100
patients were selected for the study, of whom 58 were female and 42 were
male. The total polyp count per patient ranged from 6 to 150 (median
30). The vast majority of patients (89%) had polyposis affecting the
entire large intestine. From this cohort, 406 polyps were reviewed. Most
of the polyps (83%) were serrated polyps: microvesicular hyperplastic
polyps (HP) (n=156), goblet cell HP (n=25), sessile serrated
adenoma/polyps (SSA/P) (n=110), SSA/P with cytologic dysplasia (n=28),
and traditional serrated adenomas (n=18). A further 69 polyps were
conventional adenomas. BRAF mutation was mainly detected in
SSA/P with dysplasia (95%), SSA/P (85%), microvesicular HP (76%), and
traditional serrated adenoma (54%), whereas KRAS mutation was
present mainly in goblet cell HP (50%) and in tubulovillous adenoma
(45%). Four of 6 SSA/Ps with high-grade dysplasia showed loss of
MLH1/PMS2 expression. CRC was diagnosed in 39 patients who were more
often found to have a conventional adenoma compared with patients
without CRC (P=0.003). Patients with SPS referred to genetics clinics had a pancolonic disease with a high polyp burden and a high rate of BRAF mutation. The occurrence of CRC was associated with the presence of conventional adenoma.
Saturday, July 07, 2012
paywalled- Comparison of weekly versus every 3 weeks paclitaxel in the treatment of advanced solid tumors: A meta-analysis
Comparison of weekly versus every 3 weeks paclitaxel in the treatment of advanced solid tumors: A meta-analysis
Abstract
Background
Paclitaxel
is commonly given as a 3-h infusion every 3 weeks for a variety of
malignancies. Several randomized clinical trials comparing weekly
paclitaxel with Q3-week (Q3W) have produced mixed results in terms of
efficacy and toxicity creating controversy about the ideal dose and
schedule.
Methods
A literature search using PubMed, Cochrane Library, and Proceedings of the American Society of Clinical oncology
from 1995 to 2011 was performed..........Moderators of cancer types, ethnicity, and paclitaxel dose ratio were
analyzed for primary dependent variables.
Results
Ten trials were included....
Conclusion
Weekly paclitaxel has a favorable toxicity profile compared to the current standard of Q3W paclitaxel.
Dietary Acrylamide Intake and the Risk of Lymphatic Malignancies: The Netherlands Cohort Study on Diet and Cancer
Dietary Acrylamide Intake and the Risk of Lymphatic Malignancies: The Netherlands Cohort Study on Diet and Cancer
"..Recent analyses within the NLCS, the Nurses’ Health Study, and a Danish cohort study [11], [12], [13], [14] showed a positive association for endometrial, ovarian, and estrogen receptor-positive breast cancer, suggesting that disturbance of sex hormonal balances may be a mechanism of acrylamide carcinogenesis, which can also be suggested based on the rat carcinogenicity assays [7], [8]. Although it cannot be concluded from the present study, hormonal imbalances might be a mechanism of acrylamide carcinogenesis for lymphatic malignancies as well....
Occupational cancer in Britain - ovarian, breast and cervical
Occupational cancer in Britain
"The
following paper reviews the three cancers in women: breast, cervical
and ovarian. There is no overlap between the cancers and exposure
circumstances, and thus all are considered and described separately.
Data for male breast cancer are much more limited and will not be
considered here."
Wednesday, June 20, 2012
paywalled: Nanocarrier systems for delivery of siRNA to ovarian cancer tissues, Expert Opinion on Drug Delivery
Nanocarrier systems for delivery of siRNA to ovarian cancer tissues, Expert Opinion on Drug Delivery
Expert opinion:
Gene silencing therapy based on siRNA represents a possible opportunity
for treatment of ovarian cancer patients. However, this approach
requires selection of suitable nanocarriers that can safely and
effectively deliver siRNA to the target site to induce its effect. Very
little work has been done in this field; therefore, it is a good
direction for future development.
paywalled: Cochrane Review - Removal of nail polish and finger rings to prevent surgical infection.
Cochrane Database Syst Rev. 2012 May 16;5:CD003325.
Removal of nail polish and finger rings to prevent surgical infection.
Abstract
BACKGROUND:
Surgical wound infections may be caused by the transfer of bacteria from the hands of surgical teams to patients during operations. Surgical scrubbing prior to surgery reduces the number of bacteria on the skin, but wearing rings and nail polish on the fingers may reduce the efficacy of scrubbing, as bacteria may remain in microscopic imperfections of nail polish and on the skin beneath rings.OBJECTIVES:
To assess the effect of the presence or absence of rings and nail polish on the hands of the surgical scrub team on postoperative wound infection rates.MAIN RESULTS:
We identified: no new trials; no RCTs that compared wearing of rings with the removal of rings; and no trials of nail polish versus no nail polish that measured surgical infection rates. We found one small RCT (102 scrub nurses) that evaluated the effect of nail polish on the number of bacterial colony forming units left on hands after pre-operative surgical scrubbing. Nurses had either unpolished nails, freshly-applied nail polish (less than two days old), or old nail polish (more than four days old). There were no significant differences in the number of bacteria on hands between the groups before and after surgical scrubbing.AUTHORS' CONCLUSIONS:
No trials have investigated whether wearing nail polish or finger rings affects the rate of surgical wound infection. There is insufficient evidence to determine whether wearing nail polish affects the number of bacteria on the skin post-scrub.Characteristics and Outcomes of Methicillin-Resistant Staphylococcus aureus Bloodstream Infections in Patients with Cancer Treated with Vancomycin: 9-Year Experience at a Comprehensive Cancer Center - The Oncologist
Abstract
Abstract Background. Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) can cause significant morbidity and mortality in patients with cancer. However, data
on outcomes of patients treated with vancomycin are lacking.
Methods. We identified
223 patients with cancer who developed MRSA BSIs between January 2001
and June 2009 and were treated with vancomycin.
Treatment failure was defined as death within 60
days of infection, persistent bacteremia ≥5 days, fever ≥4 days,
recurrence
or relapse, and secondary MRSA infection.
Results. The treatment
failure rate was 52% (116 of 223 patients). These patients were more
likely to have been hospitalized, been
treated with steroids within the previous 3
months, developed acute respiratory distress syndrome, required
mechanical ventilation,
required intensive care unit care, and
community-onset infections (all p < .05). Risk factors for
MRSA-associated mortality (27 of 223 patients; 12%) included hematologic
malignancy and hematopoietic
stem cell transplantation, community-onset
infection, secondary BSI, MRSA with minimum inhibitory concentration
(MIC) ≥2.0
μg/mL, mechanical ventilation, and a late switch
to an alternative therapy (≥4 days after treatment failure; all p
< .05). On multivariate analysis, mechanical ventilation and recent
hospitalization were identified as independent predictors
of vancomycin failure, and community-onset
infection, secondary BSIs, and MIC ≥2 μg/mL were identified as
significant predictors
of MRSA-associated mortality.
Conclusions. We found a
high treatment failure rate for vancomycin in patients with cancer and
MRSA BSIs, as well as a higher mortality.
A vancomycin MIC ≥2 μg/mL was an independent
predictor of MRSA-associated mortality. An early switch to an
alternative therapy
at the earliest sign of failure may improve
outcome.
paywalled: Causes of death of mutation carriers in Finnish Lynch syndrome families.
Fam Cancer. 2012 Jun 9. [Epub ahead of print]
Abstract
Lynch syndrome (LS) is an autosomal dominant cancer syndrome including increased life-long risk for colorectal (CRC) and endometrial (EC) cancer, but also for cancers of other types. The risk for CRC is up to 70-80 % and for EC up to 50-60 %. Due to screening and early diagnosing the mortality related to CRC and EC seems to be low. In spite of many studies on surveillance of mutation carriers, there is no comprehensive evaluation on causes of death in LS families. The disease history and cause of death of all the deceased, tested mutation carriers and their mutation negative relatives in the Finnish LS families (N = 179) was examined utilizing hospital records and relevant national registries. Out of 1069 mutation carriers 151 had succumbed; 97 (64 %) from cancer. Out of 1146 mutation-negative family 44 members had died; 11 (25 %) of them from cancer. In 12 (7.7 %) of the deceased mutation carriers no cancer had been diagnosed. The mean age of death from cancer was 63.2 years vs. 68.8 years from non-cancer causes. Only 7.9 % of the patients with CRC had died from CRC and 5 % of those with EC, respectively. 61 % of the cancer deaths were related to extra-colonic, extra-endometrial cancers. The cumulative overall and cancer specific death rates were significantly increased in Mut+ compared to Mut- family members. Even surveillance yields decrease in the life-long risk and mortality of the most common cancers CRC and EC in LS, almost all mutation carriers will contract with cancer, and two thirds of the deceased have died from cancer. This should be taken in account in genetic counseling. Mutation carriers should be encouraged to seek help for abnormal symptoms.Monday, June 18, 2012
paywalled - Survival of ovarian cancer patients in Germany in the early 21st century: a period analysis by age, histology, laterality, and stage
European Journal of Cancer Prevention:
Abstract
Population-based studies on ovarian cancer providing
survival estimates by age, histology, laterality, and stage have been
sparse. We aimed to derive the most up-to-date and detailed survival
estimates for ovarian cancer patients in Germany. We used a pooled
German national dataset including data from 11 cancer registries
covering 33 million populations. A total of 21 651 patients diagnosed
with ovarian cancer in 1997-2006 were included. Period analysis was
carried out to calculate the 5-year relative survival (RS) for the years
2002-2006. Trends in survival between 2002 and 2006 were examined using
model-based period analysis. Age adjustment was performed using five
age groups (15-44, 45-54, 55-64, 65-74, and 75+ years). Overall, the
age-adjusted 5-year RS in 2002-2006 was 41%. A strong age gradient was
observed, with a decrease in the 5-year RS from 67% in the age group
15-49 years to 28% in the age group 70+ years. Furthermore, the
prognosis varied markedly by histology, laterality, and stage, with the
age-adjusted 5-year RS ranging from 25% (for carcinoma not otherwise
specified) to 81% (for stromal cell carcinoma), reaching 46% for
unilateral and 32% for bilateral carcinoma and reaching 82% for
Federation of Gynecology and Obstetrics (FIGO) stages I and II, 36% for
FIGO stage III, and 18% for FIGO stage IV. No improvement in survival
could be observed for any of the subgroups in the period between 2002
and 2006. Our analyses suggest that an improvement in the 5-year RS for
ovarian cancer may have stagnated in the early 21st century and
underline the need for a more effective translation of therapeutic
innovation into clinical practice.
CDC- Cancer Survivorship Twitter Chat Tuesday, June 19th 2-3 pm EDT
Join Us! Cancer Survivorship Twitter Chat Tomorrow
Centers for Disease Control and Prevention (CDC)
CDC's Division of Cancer Prevention and
Control (DCPC) will host a Twitter chat about cancer survivorship on
Tuesday, June 19 from 2:00 to 3:00 pm EDT.
Subject matter experts Blythe Ryerson and Dr. Elizabeth Rohan will answer questions. Visit DCPC's Twitter account at twitter.com/CDC_Cancer. You can follow the chat using the hashtag #CDCCancerChat, and you can send questions for the chat using that hashtag now.
Division of Cancer Prevention and Control
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
Subject matter experts Blythe Ryerson and Dr. Elizabeth Rohan will answer questions. Visit DCPC's Twitter account at twitter.com/CDC_Cancer. You can follow the chat using the hashtag #CDCCancerChat, and you can send questions for the chat using that hashtag now.
Division of Cancer Prevention and Control
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
Subscribe to:
Posts
(
Atom
)
